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Personality Disorder

Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Jonathan Green, Carolyn A Chew-Graham, Nav Kapur, Darren M Aschcroft

Type
Disease or Syndrome
ID
PH590
Version ID
1180
Data Sources
Valid event data range
01/01/2001 - 31/12/2014
Sex
Female, Male
Agreement Date
2017-10-18
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Objectives:

To examine temporal trends in sex and age specific incidence of self harm in children and adolescents, clinical management patterns, and risk of cause specific mortality following an index self harm episode at a young age.

Design:

Population based cohort study.

Setting:

UK Clinical Practice Research Datalink—electronic health records from 674 general practices, with practice level deprivation measured ecologically using the index of multiple deprivation. Patients from eligible English practices were linked to hospital episode statistics (HES) and Office for National Statistics (ONS) mortality records.

Participants:

For the descriptive analytical phases we examined data pertaining to 16 912 patients aged 10-19 who harmed themselves during 2001-14. For analysis of cause specific mortality following self harm, 8638 patients eligible for HES and ONS linkage were matched by age, sex, and general practice with up to 20 unaffected children and adolescents (n=170 274).

Main outcome measures:

In the first phase, temporal trends in sex and age specific annual incidence were examined. In the second phase, clinical management was assessed according to the likelihood of referral to mental health services and psychotropic drug prescribing. In the third phase, relative risks of all cause mortality, unnatural death (including suicide and accidental death), and fatal acute alcohol or drug poisoning were estimated as hazard ratios derived from stratified Cox proportional hazards models for the self harm cohort versus the matched unaffected comparison cohort.

Results:

The annual incidence of self harm was observed to increase in girls (37.4 per 10 000) compared with boys (12.3 per 10 000), and a sharp 68% increase occurred among girls aged 13-16, from 45.9 per 10 000 in 2011 to 77.0 per 10 000 in 2014. Referrals within 12 months of the index self harm episode were 23% less likely for young patients registered at the most socially deprived practices, even though incidences were considerably higher in these localities. Children and adolescents who harmed themselves were approximately nine times more likely to die unnaturally during follow-up, with especially noticeable increases in risks of suicide (deprivation adjusted hazard ratio 17.5, 95% confidence interval 7.6 to 40.5) and fatal acute alcohol or drug poisoning (34.3, 10.2 to 115.7).

Conclusions:

Gaining a better understanding of the mechanisms responsible for the recent apparent increase in the incidence of self harm among early-mid teenage girls, and coordinated initiatives to tackle health inequalities in the provision of services to distressed children and adolescents, represent urgent priorities for multiple public agencies.

Publications

  • Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Jonathan Green, Carolyn A Chew-Graham, Nav Kapur, Darren M Aschcroft, Incidence, clinical management, and mortality risk following self harm among children and adolescents cohort study in primary care. BMJ, 359(j4351), 2017.

Clinical Code List

Rows: 81
Code Description Entity type Category Coding System (Read)
E21..00 Personality disorders res59: Personality_disorder diagnostic Read
E21..11 Neurotic personality disorder res59: Personality_disorder diagnostic Read
E210.00 Paranoid personality disorder res59: Personality_disorder diagnostic Read
E211.00 Affective personality disorder res59: Personality_disorder diagnostic Read
E211000 Unspecified affective personality disorder res59: Personality_disorder diagnostic Read
E211100 hypomanic personality disorder res59: Personality_disorder diagnostic Read
E211200 depressive personality disorder res59: Personality_disorder diagnostic Read
E211300 cyclothymic personality disorder res59: Personality_disorder diagnostic Read
E211z00 Affective personality disorder NOS res59: Personality_disorder diagnostic Read
E212.00 schizoid personality disorder res59: Personality_disorder diagnostic Read
E212000 unspecified schizoid personality disorder res59: Personality_disorder diagnostic Read
E212z00 schizoid personality disorder nos res59: Personality_disorder diagnostic Read
E213.00 Explosive personality disorder res59: Personality_disorder diagnostic Read
E214.00 Compulsive personality disorders res59: Personality_disorder diagnostic Read
E214.11 Anancastic personality res59: Personality_disorder diagnostic Read
E214000 Anankastic personality res59: Personality_disorder diagnostic Read
E214z00 Compulsive personality disorder NOS res59: Personality_disorder diagnostic Read
E215.00 Histrionic personality disorders res59: Personality_disorder diagnostic Read
E215.11 Hysterical personality disorders res59: Personality_disorder diagnostic Read
E215000 Unspecified histrionic personality disorder res59: Personality_disorder diagnostic Read
E215z00 Histrionic personality disorder NOS res59: Personality_disorder diagnostic Read
E216.00 Inadequate personality disorder res59: Personality_disorder diagnostic Read
E217.00 Antisocial or sociopathic personality disorder res59: Personality_disorder diagnostic Read
E21y.00 Other personality disorders res59: Personality_disorder diagnostic Read
E21y000 Narcissistic personality disorder res59: Personality_disorder diagnostic Read
E21y100 Avoidant personality disorder res59: Personality_disorder diagnostic Read
E21y200 Borderline personality disorder res59: Personality_disorder diagnostic Read
E21y300 Passive-aggressive personality disorder res59: Personality_disorder diagnostic Read
E21y400 Eccentric personality disorder res59: Personality_disorder diagnostic Read
E21y500 Immature personality disorder res59: Personality_disorder diagnostic Read
E21y600 Masochistic personality disorder res59: Personality_disorder diagnostic Read
E21y700 Psychoneurotic personality disorder res59: Personality_disorder diagnostic Read
E21yz00 Other personality disorder NOS res59: Personality_disorder diagnostic Read
E21z.00 Personality disorder NOS res59: Personality_disorder diagnostic Read
E21z.11 Psychopathic personality res59: Personality_disorder diagnostic Read
Eu06000 [X]Organic personality disorder res59: Personality_disorder diagnostic Read
Eu06011 [X]Organic pseudopsychopathic personality res59: Personality_disorder diagnostic Read
Eu21.17 [x]pseudopsychopathic schizophrenia res59: Personality_disorder diagnostic Read
Eu21.18 [x]schizotypal personality disorder res59: Personality_disorder diagnostic Read
Eu34011 [X]Affective personality disorder res59: Personality_disorder diagnostic Read
Eu34112 [x]depressive personality disorder res59: Personality_disorder diagnostic Read
Eu60.00 [X]Specific personality disorders res59: Personality_disorder diagnostic Read
Eu60000 [X]Paranoid personality disorder res59: Personality_disorder diagnostic Read
Eu60013 [X]Querulant personality disorder res59: Personality_disorder diagnostic Read
Eu60014 [X]Sensitive paranoid personality disorder res59: Personality_disorder diagnostic Read
Eu60100 [x]schizoid personality disorder res59: Personality_disorder diagnostic Read
Eu60200 [X]Dissocial personality disorder res59: Personality_disorder diagnostic Read
Eu60211 [X]Amoral personality disorder res59: Personality_disorder diagnostic Read
Eu60212 [X]Antisocial personality disorder res59: Personality_disorder diagnostic Read
Eu60213 [X]Asocial personality disorder res59: Personality_disorder diagnostic Read
Eu60214 [X]Psychopathic personality disorder res59: Personality_disorder diagnostic Read
Eu60215 [X]Sociopathic personality disorder res59: Personality_disorder diagnostic Read
Eu60300 [X]Emotionally unstable personality disorder res59: Personality_disorder diagnostic Read
Eu60311 [X]Aggressive personality disorder res59: Personality_disorder diagnostic Read
Eu60312 [X]Borderline personality disorder res59: Personality_disorder diagnostic Read
Eu60313 [X]Explosive personality disorder res59: Personality_disorder diagnostic Read
Eu60400 [X]Histrionic personality disorder res59: Personality_disorder diagnostic Read
Eu60411 [X]Hysterical personality disorder res59: Personality_disorder diagnostic Read
Eu60412 [X]Psychoinfantile personality disorder res59: Personality_disorder diagnostic Read
Eu60500 [X]Anankastic personality disorder res59: Personality_disorder diagnostic Read
Eu60511 [X]Compulsive personality disorder res59: Personality_disorder diagnostic Read
Eu60512 [X]Obsessional personality disorder res59: Personality_disorder diagnostic Read
Eu60513 [X]Obsessive-compulsive personality disorder res59: Personality_disorder diagnostic Read
Eu60600 [x]anxious [avoidant] personality disorder res59: Personality_disorder diagnostic Read
Eu60700 [X]Dependent personality disorder res59: Personality_disorder diagnostic Read
Eu60711 [X]Asthenic personality disorder res59: Personality_disorder diagnostic Read
Eu60712 [X]Inadequate personality disorder res59: Personality_disorder diagnostic Read
Eu60713 [X]Passive personality disorder res59: Personality_disorder diagnostic Read
Eu60714 [X]Self defeating personality disorder res59: Personality_disorder diagnostic Read
Eu60800 [X]Addictive personality res59: Personality_disorder diagnostic Read
Eu60y00 [X]Other specific personality disorders res59: Personality_disorder diagnostic Read
Eu60y11 [X]Eccentric personality disorder res59: Personality_disorder diagnostic Read
Eu60y12 [X]Haltlose type personality disorder res59: Personality_disorder diagnostic Read
Eu60y13 [X]Immature personality disorder res59: Personality_disorder diagnostic Read
Eu60y14 [X]Narcissistic personality disorder res59: Personality_disorder diagnostic Read
Eu60y16 [X]Psychoneurotic personality disorder res59: Personality_disorder diagnostic Read
Eu60z00 [X]Personality disorder; unspecified res59: Personality_disorder diagnostic Read
Eu60z11 [X]Character neurosis NOS res59: Personality_disorder diagnostic Read
Eu60z12 [X]Pathological personality NOS res59: Personality_disorder diagnostic Read
Eu61.00 [X]Mixed and other personality disorders res59: Personality_disorder diagnostic Read
Eu84511 [x]autistic psychopathy res59: Personality_disorder diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH590/version/1180/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH590/version/1180/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH590', '1180', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH590/version/1180/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH590/version/1180/export/codes/?format=json
CSV site_root/phenotypes/PH590/version/1180/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH590', '1180', api_client=client)

Version History

Version
ID
Name Owner Publish date
1180 Personality Disorder ieuan.scanlon 2021-10-06 currently shown

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